What is the clinical evidence from this study?

Study design: Cohort. Population: IgA nephropathy (n=168). Intervention: ACE genotype II vs. ACE genotypes ID or DD. Primary outcome: Progression of renal disease (elevation of serum creatinine above 125 microM in men or 105 microM in women and over 20% from baseline).

What question did this study set out to answer?

To determine whether the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism influences long-term prognosis and disease progression in patients with IgA nephropathy.

January 1, 2000The Nephron journals/Nephron journals

Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Prognosis of IgA Nephropathy

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Key result

ACE genotype II was associated with a more favorable prognosis for renal disease progression in IgA nephropathy compared to genotypes ID or DD, with 15% of the overall cohort progressing over 11 years.

Why the study?

Does ACE gene I/D polymorphism affect the progression of renal disease in patients with IgA nephropathy?

Key Points

To determine whether the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism influences long-term prognosis and disease progression in patients with IgA nephropathy.
Followed 168 patients with biopsy-confirmed IgA nephropathy over a median follow-up of 11 years (range 6–17 years).
Defined renal progression as a serum creatinine rise >20% above baseline exceeding 125 µM (1.4 mg/dl) in men or 105 µM (1.2 mg/dl) in women, alongside serial proteinuria assessments.
Renal disease progression developed in 26 of 168 patients (15%), with individuals carrying the ACE genotype II experiencing a significantly more favorable clinical course than those with ID or DD genotypes.
Proteinuria ≥1 g/24 h was comparable across genotypes at initial biopsy, but occurred with significantly higher frequency in ID and DD genotypes than in the II genotype at final follow-up.
No statistically significant associations were detected between ACE genotypes and hypertension, serum lipids, or serum urate levels.

Study Design

Type

Cohort (n=168)

Structured PICO

Does ACE gene I/D polymorphism affect the progression of renal disease in patients with IgA nephropathy?

Population

168 patients with IgA nephropathy

Intervention

ACE gene I/D polymorphism (genotypes ID or DD)

Comparator

ACE genotype II

Outcome

Progression of renal disease defined as elevation of serum creatinine above 125 microM (1.4 mg/dl) in men or 105 microM (1.2 mg/dl) in women and over 20% from the baseline levelsurrogate

Patients with IgA nephropathy and the ACE genotype II have a more favorable prognosis and better resolution of proteinuria compared to those with genotypes ID or DD.

Discussion

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Implication

ACE II may inform IgA nephropathy prognosis; leaves open whether genotyping improves risk stratification or warrants trials.

Cite This Study

Syrjänen et al. (2000) conducted a cohort in IgA nephropathy (n=168). ACE genotype II vs. ACE genotypes ID or DD was evaluated on Progression of renal disease (elevation of serum creatinine above 125 microM in men or 105 microM in women and over 20% from baseline). ACE genotype II was associated with a more favorable prognosis for renal disease progression in IgA nephropathy compared to genotypes ID or DD, with 15% of the overall cohort progressing over 11 years.

synapsesocial.com/papers/6a176a2c40149b897cb401b7 https://doi.org/10.1159/000045728

Topics

Hypertension management

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Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Prognosis of IgA Nephropathy

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Prognosis of IgA Nephropathy

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider